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Remote Utilization Review Rn Jobs in Plymouth, MN

Position Type: Part-Time, Remote Shifts Available: Weekend Days: 7:00 am - 7:00 pm Saturday ... After-Hours RN Qualifications: * Must have a current Minnesota RN license and be in good standing.

Position Type: Part-Time, Remote Shifts Available: Weekend Days: 7:00 am - 7:00 pm Saturday ... After-Hours RN Qualifications: * Must have a current Minnesota RN license and be in good standing.

REMOTE MDS Coordinator

Minneapolis, MN · On-site +1

$35.75 - $45.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Review and verify MDS documentation and charting requirements to support the clinical services ...

REMOTE MDS Coordinator

Minneapolis, MN · On-site +1

$35.75 - $45.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Review and verify MDS documentation and charting requirements to support the clinical services ...

REMOTE MDS Coordinator

Minneapolis, MN · Remote

$35.75 - $45.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Review and verify MDS documentation and charting requirements to support the clinical services ...

NCLEX-RN Tutor

Edina, MN · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

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Remote Utilization Review Rn information

See Plymouth, MN salary details

$22

$44

$72

How much do remote utilization review rn jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for remote utilization review rn in Plymouth, MN is $44.63, according to ZipRecruiter salary data. Most workers in this role earn between $35.29 and $51.25 per hour, depending on experience, location, and employer.

What is a remote utilization review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What are the key skills and qualifications needed to thrive as a remote utilization review RN?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What are some common challenges remote utilization review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.

What is the difference between Remote Utilization Review Rn vs Remote Case Manager Rn?

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are popular job titles related to Remote Utilization Review Rn jobs in Plymouth, MN?

For Remote Utilization Review Rn jobs in Plymouth, MN, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Plymouth, MN look for?

The top searched job categories for Remote Utilization Review Rn jobs in Plymouth, MN are:

What cities near Plymouth, MN are hiring for Remote Utilization Review Rn jobs?

Cities near Plymouth, MN with the most Remote Utilization Review Rn job openings:

Infographic showing various Remote Utilization Review Rn job openings in Plymouth, MN as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $92,822 per year, or $44.6 per hour.

Utilization Management RN

North Memorial Health

Robbinsdale, MN • On-site, Remote

$39.83 - $59.74/hr

Full-time, Part-time

Medical, Retirement, PTO

Re-posted 27 days ago


North Memorial Health rating

7.6

Company rating: 7.6 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

192nd of 898 rated healthcare providers


Job description

Utilization Management RN
Robbinsdale, MN
Posting Date: Sep 04 2026
Requisition Number: 514471
Why North Memorial Health?
At North Memorial Health, you're part of an inclusive health team that is rooted in our values: Advocate Courageously, Rally Together, Respect Uniqueness and Create Impact. Empathy and care are at the heart of North's culture which is designed to actively support each team member's wellbeing and growth. Our strength lies in our diversity, and we embrace the unique contributions and experiences of each person. Together, we empower patients to achieve their best health.
Our health system encompasses two hospital locations in Robbinsdale and Maple Grove as well as a network of 23 clinics which includes 13 primary clinics, 6 specialty clinics, 4 urgent care/urgency centers and emergency care offerings covering five counties. Our Robbinsdale Hospital, established in 1954, is a 385-bed facility recognized as the top Level 1 Trauma center for 25 years, as well as serving as a Level II pediatric trauma center. Our Maple Grove Hospital was established in 2009, is a 134-bed facility recognized as a top hospital in the state for Women and Children Care, with a Level III NICU, and is the largest Family Birth Center in the state (~5,000 deliveries per year and over 60,000 babies delivered). Both have been named to the 2022 Fortune/Merative 100 Top Hospitals® list, 2023 Women's Choice Award Best Hospitals list.
Benefits the North Way!
As North Memorial Health is a non-profit organization you are eligible for the Public Student Loan Forgiveness program. Most part-time and all full-time positions are eligible for benefits.
  • Health & Welfare Benefit Packages
  • 401k Retirement Match or Pension Plan, based on workgroup eligibility
  • Generous Paid Time Off (PTO) Plans
  • Adoption Reimbursement up to $3000 per child
  • Child Care Discount Program with New Horizon 10% off weekly childcare tuition
  • Education/Tuition Reimbursement
  • 24/7 Fitness Center Access for all benefit eligible team members

Commitment to Diversity, Equity & Inclusion
At North Memorial Health we recognize that the strength of our team lies in our diversity and make every effort to embrace the unique contributions and experiences of each person on our team. We strive to ensure that everyone feels like they are a valuable part of our community, with initiatives that reinforce our belief in diversity, equity, and inclusivity, to promote a workforce that enables authenticity, as we want to be our best when providing effective services to our patients. We acknowledge and celebrate the unique traditions, backgrounds, languages, beliefs, and customs of our community, and want everyone to feel welcome. Through our DE&I initiatives we hope to dispel myths, assumptions, and acts of implicit bias.
About this position
The Utilization Management RN, under the supervision of the Utilization Management Manager, acts as a support resource to the Medical Staff of North Memorial Health (NMH) and Maple Grove Hospital (MGH) in relationship to clinical documentation of admitted customers. The UM RN assess the documented medical necessity of each bedded patient to assist the MD as needed to determine an appropriate admission status. They provide clinically based information to assist with care coordination and support the delivery of quality customer care as efficiently as possible. The RN has accountability for assisting in ensuring quality clinical outcomes, and appropriate resource management related to admission, readmission, length of stay, extended stay, avoidable days and discharge planning. They work with the medical and care teams (nursing, social services, therapies, and ancillary departments) to ensure the customer is receiving the right care, at the right level across the continuum. Additionally, they know the disease, trajectory of illness, treatment plan, standard of care for the diagnosis, expected outcome, and Length of Stay (LOS) for the case type. They work with all admissions (bedded customers) excluding any customers in the Emergency Department Finally, they UM RN actively and consistently demonstrates the mission, vision, values and guiding principles of North Memorial Health.
Requirements
Education
• Bachelor's Degree from an accredited school of nursing required.
Experience
• Three (3) to five years of previous acute care nursing experience required.
• 1-2 years of direct utilization review experience preferred.
• One (1) year of direct case management experience required.
• Hospital case management and utilization management experience required. • Knowledge of nursing theory and practice and primary care principles and practices.
• Knowledge of Medicare rules and regulations.
• Knowledge of current case management principles, utilization management, length of stay management, and/or transition/discharge planning.
• Knowledge of current nursing principles, techniques and procedures.
• Demonstrated ability to deal with conflict in a positive manner. Has an awareness of, responds to, and considers the needs, feelings and capabilities of others.
• Strong communication skills with demonstrated ability to express ideas and information clearly and concisely in a manner appropriate to the audience.
Licensure/Certification
Current licensure and registration as an RN in the State of MN. - State Requirement
The North Memorial Health System is dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role, but your past experience doesn't perfectly align with every qualification listed, we encourage you to apply anyway. You may still be the right candidate for this or other roles.
Work Group: Non Contract
Hours per two week pay period: 80
Shift: Days 8 hours
Weekend Requirement: Every Other Weekend
Call Requirement: None
Remote or On-site: Hybrid Remote- Must live in MN or WI
FLSA Status: Exempt
Benefit Eligibility: Health insurance benefits are available for this position. North Memorial Health offers multiple health plans based on work group eligibility.
Salary Range: N23 ($39.83 - $59.74), based on experience
Shift Differential: Compensation may include shift differential pay depending on the position and shift worked.
STI Bonus Eligible: False
Employment Sponsorship: Applicants must be currently authorized to work in the United States on a full-time basis. Work visa sponsorship is not available for this position
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EEO/AA STATEMENT
North Memorial Health is an equal employment and affirmative action employer. North Memorial Health does not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, age, disability, genetic information, marital status, veteran status, sexual orientation, gender identity, creed, status with respect to public assistance, or other protected class status. North Memorial Health provides reasonable accommodation to disabled applicants and employees and takes affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to protected class status. If you believe that you have been treated in a way that does not conform to these statements, please contact our HR Service Center: JobApplicationAssistance@NorthMemorial.com. If you need a reasonable accommodation, due to a disability, or to assist with the application process, please contact our HR Service Center: JobApplicationAssistance@NorthMemorial.com.
INSPECTION OF AAP
North Memorial Health is a Federal government contractor or subcontractor.
As a part of our obligations under law, we must develop a written Affirmative Action Program for Individuals with Disabilities and Protected Veterans, as specified by law (AAP).
This AAP is available for inspection by applicants and employees in the Human Resources Office during normal business hours.
Link to Policy
North Memorial Health
Be challenged. Be empowered. Be accountable. Join an empowering, supportive, and responsive environment that delivers unmatched customer service - not only for the community we serve but our own team members, too.

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